Second-look endoscopy is not associated with better clinical outcomes after gastric endoscopic submucosal dissection: a prospective, randomized, clinical trial analyzed on an as-treated basis - 17/07/13
Riassunto |
Background |
The efficacy of routine second-look endoscopy (SLE) to detect or prevent bleeding after gastric endoscopic submucosal dissection (ESD) has not yet been validated.
Objective |
The aim of this study was to determine whether SLE affects clinical outcomes including bleeding and morbidity after gastric ESD.
Design |
A prospective, randomized, controlled study with consecutive data analyzed on an as-treated basis.
Setting |
A single, tertiary-care referral center.
Patients |
A total of 182 patients.
Intervention |
Gastric ESD and SLE.
Main Outcome Measurements |
Incidence of and risk factors related to bleeding after ESD and outcomes by univariate or multivariate analysis.
Results |
Among 182 patients enrolled, 74 and 81 patients were assigned to the SLE and no-SLE groups, respectively. Two groups were observed closely for 4 weeks. Bleeding occurred after ESD in 21 patients (13.5%). Hemoglobin loss (≥2.0 g/dL) was observed in 20 patients, and melena developed in 1 patient after ESD. However, only 1 patient needed a transfusion. Twelve patients (16.2%) in the SLE group and 9 in the no-SLE group (11.1%) experienced bleeding after ESD. The frequency of bleeding after ESD was not significantly different between the 2 groups (P = .66). There were no risk factors related to bleeding after ESD.
Limitations |
Single-center analysis.
Conclusion |
SLE is not routinely necessary because it does not affect clinical outcomes, including bleeding and morbidity after ESD. (Clinical trial registration number: KCT0000146.)
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : APC, aPTT, ESD, PT, SLE
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| DISCLOSURE: This research was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education, Science and Technology (2012-0004734) and Chong Kun Dang Pharmaceutical Corporation. No other financial relationships relevant to this publication were disclosed. |
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| If you would like to chat with an author of this article, you may contact Dr Kim at hyskim@yonsei.ac.kr. |
Vol 78 - N° 2
P. 285-294 - agosto 2013 Ritorno al numero
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